Wheetsin

I have a very high pain tolerance, and (so far) have recovered very quickly from surgeries. With both my lap-band and agllbladder surgeries I slept in a recliner. I could get up/down, walk around, do stairs, etc. with no problems but getting in to bed was too uncomfortable until about day 4. Sitting up from the recliner hurt, but not nearly as bad as trying to lay in bed. On day 4 (maybe it was 3, maybe it was 5) after lap-band I slept in bed with several pillows propping me up, and a body pillow to support the weight of my pannus. After GB I slept in bed the 2nd night. I'm not sure why the bed was so uncomfortable. The day after surgery I went walking around in Target, and went to GNC. The next day we took an hour car trip out of town and spent the day with my parents and I was fine. Pain levels all tolerable. Unless I tried to get into/out of bed.

Sorry Tiffykins, I didn't mean to duplicate you. I started responding, then had to step away, and didn't see your reply.

According to BMI charts, these men are all morbidly obese or super morbidly obese. I'm guessing they have > 5% body fat, and probably closer to 2% - 4% (guessing). Do you think they are accurate measurement tools?

Hi dalistone, I'm in the KC area. Since one of the only surgeons around who does the sleeve is in KS I'm sure there are several people who are "here" geographically, but not "here" on this board. I currently have a lap-band, and know about 40 people in MO and KS who are also banded or have been banded, but don't personally know any sleevers -- that I know about. My band has slipped and I'm working on a sleeve revision. I think. Communication-wise it's a 1 way street so far, so I hope I'm not just in limbo. 35 y/o female here.

99% of what GPs see is the same thing day in, day out. They have very broad, general backgrounds. Back when I had my lap-band, my GP had heard of it because some of her other patients had already had it done. Because of them, she wanted to read up on it and its stats, and she was actually pretty well informed when I talked to her (she thought it was great, was impressed by the numbers, actually explained to me a little more about the technical/medical side, etc.) I would assume so many people know about lap-band & RNY now because they're in the media, and not unrelated - they're the "procedures of choice." From commercials to reality shows to dramatic series - I've seen RNY or lap-band on all of them, and I watch very little TV. Funny enough, what I hear is usually wrong. E.g. "She had gastric bypass, which means there's a band around her stomach." A good friend of mine is a GP. When I talked to her about the sleeve, she didn't know what it was and assumed it was some sort of a tube that was inserted into the stonach and "lined" it, like a reversed shirt sleeve. I also have a good friend who is an ER doc. She and I have talked about my band many times (I"ve actually been able to help her a few times when she's gotten "stuck" patients into the ER seeking emergency unfills). She knows I'm looking into the sleeve, and so far (knock on wood) isn't aware of any patients passing through her ER because of their procedure.

I'm seeing two needs. One is the immediate need of living with the band until something can be done. Two is your insurance. You sound either slipped, or way too tight to me. I have a hard time focusing on "wall of text" posts (no offense) -- so I may have missed it -- but do you currently have fill or are you unfilled? If you have fill, get it taken out. Are you actually vomiting (are you purging the contents of your stomach) or are you "PBing" or bringing up the stuck band stuff (saliva, perhaps a few bits of food, foam, etc.)? Vomiting and PBing are two completely different things, and it's important to know which you're actually experiencing. In either case, if you're truly bringing up either vomit or "stuck band stuff" routinely, then you're also swollen routinely, and that will be exacerbated by more eating, yakking, vicious cycle ad infinitum. I personally would suggest you go on liquids for a week, or better - two. Give yourself a chance to recover, unswell (is there a term for that?), etc. Then gradually work your way through mushies and on to solids over the course of a few more days, and see if that helps. If your band is toast, it's toast -- but a "back to basics" routine can do wonders to make things more tolerable. Did your surgeon order an EGD, or at least an xray or fluoroscopy or anything to diagnose what's happening? Your band isn't actually malfunctioning, I don't think (e.g.it sounds like fluid makes its way to the band, and the band is doing its job of restricting) so something else is happening and you need to figure out what. MOST (all that I know of, but there may be an exception) insurance companies will require medical evidence of a slip or erosion to approve removal/revision. You can't just tell them it's not working, and neither can your surgeon, and have that be enough. They won't "take someone's word" so to speak. My insurance company required an EGD as proof - even the xray showing it in the wrong position was not enough, nor was a 2+ year history of documented onset of reflux related to the band. It doesn't sound like your surgeon's office submitted anything like that (because it doesn't sound like they had anything to submit). Find out what your insurance company requires as proof of medical need, and then schedule it with your surgeon. Better yet, ask your surgeon's office why they didn't do it to begin with, and then inform them that they will be doing it. Until you meet their requirements, you will be denied. It will be the same as asking them, "Please? I really want it." Meeting the BMI of the surgery sounds like a miscommunication. There is no BMI requirement for removal, and I would doubt there's one for revision IF revision is done for reason of medical necessity (unless excluded). I'm thinking there's a chance that, since (apparently) no proof of medical need was documented/submitted, your request may have been interpretted as a voluntary removal, and "medically necessary" second procedure -- which will be treated as an initial procedure (at best), and for which standard requirements most likely apply. HTH, and let us know what you find out.

Totally dependent on the surgeon. My surgeon requires a 2 day post-op diet. I've known others to be required a 6 week diet. 1 - 3 days is generally sufficient for the initial shrinkage but as always - do what your surgeon requires.

Yes, you can include YOUR flight. If you elect to take spouse, children, etc. you cannot deduct their flights. (I'm assuming they don't specify flight along with taxi, bus, etc. because it's relatively unusual to fly somewhere for surgical treatment.) This reimbursement is still subject to the 7.5% limitation. Keep in mind this is a deduction, not a credit. That one really messes people up sometimes. A deduction reduces your taxable income. A credit is a dollar-for-dollar tax reduction. I take a $2000 deduction on $100,000 worth of income. My taxable income becomes $98,000. A $2000 tax credit would reduce my taxes owed by $2000. (We built a house in 2010, and qualified for the $6,500 homeowner credit, and a $1500 energy star credit, so our actual tax refund was increased by $8,000 over what it would have been otherwise). This is all really simplified, so forgive any technicalities I've left out. You guys owe me when I get my sleeve & have a bunch of sleeve questions.

Chatty - in the lap-band world (and from what I've read it's in the sleeve world too, though I personally don't know yet) we have what's called a "soft stop." Soft stop being your body's warning sign that you're reaching your limit food-wise and need to pass on that next bite, or else. Hard stop being when you have to yak the food back up. Soft stops are usually one of these: Sneezes (usually either one, or a series of several) Watery eyes Hiccups An unintentional sigh Small burp that tastes like whatever bite you had last Combination hiccup/burp or "hiccurp" The best medical explanation I have read is that it's an effect of the vagus nerve having additional pressure applied from the expanding pouch or stomach. I don't know if that's what you're experiencing, but maybe - I know some sleevers do.

Don't worry about bombarding me - I'm happy to help if I can. But I'm not a tax preparer, or an insurance claims professional -- I work on the ancillary corporate performance side. I sat next to actuaries and underwriters and tax attorneys so I've picked up a lot of information, but it's not my profession directly. Having said that, these answers are to the best of my knowledge, but I would strongly advise you to follow-up with a pro before you take my word. 1. WLS is generally not considered a "weight loss program." That term tends to apply to things like Weight Watchers, and NutriSystem. You cannot (or could not, last I actually kept up with a lot of this stuff) deduct things like gym memberships or weightloss club fees, nor the cost of "diet food." In 2002 (IIRC) the IRS categorized obesity as a disease, which is when programs became deductible. Anything that's not a recognized "program" is not considered treatment of disease (just as you could not deduct aromatherapy for treatment of heart disease, even if it did help you remain calm and stress-free). I think it MAY also depend on the procedure. In... 2009? the IRS approved Gastric Bypass/RNY for tax deduction. I don't know if that approval is specific to RNY, or can be more widely applicable to bariatrics. But I will call a friend of mine who will know, and see what she says. I have great insurance and a good income, so my expenses have never exceeded the AGI threshhold so this is not one of the tax sectors I try to keep up on. 2. I actually looked into this around 2007 when I saw how horrible my skin was becoming with my weightloss from lap-band. At the time, the answer was no (assuming you're asking about plastics for saggy skin). I wonder, though, if someone armed with enough evidence could fight that. Could we make the argument that obesity is a disfiguring disease? I'm not sure. It depends on their use of disease (e.g. "cancer" is a disease, but cancer because of actions you have done to yourself, such as lung cancer from smoking cigarettes, can sometimes be excluded -- and I wonder if obesity would be too, since it's a self-inflicted disease.) Here's my best guess. Plastic surgery specifically for body function might be deductible. Plastic surgery for cosmetic reasons would not be. I think a panniculectomy may be deductible, since it is a procedure specifically for removing only skin, if you had medical evidence of necessity (e.g. a history of Dr. visits for treatment of skin sores, yeast infections in the area, etc.) I doubt a lower body lift would be deductible. Having said that, I know that breat augmentation following mastectomy has been successfully deducted, and one could argue that fake breasts are "unnecessary" and only for "improving the patient's appearance," and that absence of a breast or breasts "does not meaningfully promote the proper function of the body." 3, Yes! For procedures after 2002. Your travel costs can also be deducted, unless they are included in the cost of your procedure (e.g. if procedure cost includes hotel stay). Make sure to keep ALL of your paperwork - receipts, doctor/surgeon letters, etc. Oh and a little birdy once told me that if you call a tax office (rhymes with waych sand car lock), even if they don't do your taxes, they will answer your tax questions free of charge, year-round, though for help in the off season (roughly June - Oct) you'll need to get in touch with a district office. They have two types of tax offices: standard and premium. Premium offices have more experienced tax professionals. I can't attest to the accuracy of any of this, but you might want to tuck it away under "good to know."

Oh, do mash them down with a fork. If not, you will have ball cookies and they're kinda awkward to eat.

I've been making flourless PB Cookies forever. I have no idea what the food Network recipe is, but I don't mind sharing mine. <LI class="plaincharacterwrap ingredient">1 cup peanut butter<LI class="plaincharacterwrap ingredient">1 cup white sugar<LI class="plaincharacterwrap ingredient">1 egg Preheat to 350. Combine all ingredients. Make your cookies. Bake for 8 minutes. Make sure you let them cool completely before you take them off the rack or they'll come apart. I have substituted Splenda for sugar with no problems.

Slips are weird in that way. I have restriction. I'm not going to say a LOT, when I can eat I can eat about as much as I want, but there are still plenty of times when I'll just skip meals b/c it's too uncomfortable to eat. And I'm still full a LOT sooner than I would be with nothing ("as much as I want" is still under a full portion). Yesterday I ate a small plate of Cheez-Its just fine. About 45 mins later went to drink some apple juice and ended up sliming over it. I came |----| close to having to having to yak, which I haven't had to do in months & months & months. That's a slip, and no fill, and not TOM. I haven't heard anything about my removal since the EGD was scheduled. I need to call. I'm really not impressed with the way this is being handled. I know my surgeon's office is busy, but I don't think my expectations are too high when I saw that I just want to know what comes next... and maybe a guess as to when.

Out of pocket maximums only apply to covered procedures, that I know of. Elective procedures do not count towards them - elective meaning excluded from your plan. E.g. if your out of pocket maximum was $2000, you could not have breast implants and pay $6000, and consider yourself having met your maximum. You could pay $2000 toward a $40,000 procedure, pretending $2000 was your portion of the agreed charge, and consider yourself having met the maximum. Hope that helps. The statement should indicate the charges and what your balance is, if any. A statement of "anything over $10,000 should be deductible" is not accurate. Eligibility for deduction is on a percentage basis, not a flat rate. Here's the skinny... (Would you believe I've worked for both a very large insurance company, and a very large tax company? I swear it's true!) You can only deduct medical costs that exceed 7.5% of your AGI. So the formula is: AGI * .075 = 75% of AGI. Your expenses - 75% of AGI = allowed deduction. Let's say your AGI is $100,000, and your deductible medical expenses are $5000. (not all expenses are deductible) $100,000 * .075 = $7500. $5000 - $7500 = no deduction for you. Let's say your AGI is $20,000 and your deductible medical expenses are $5000. $20,000 * .075 = $1500. $5000 - $1500 = $3500 deduction. If what your CPA told you is accurate and $10,000 is 75% of your AGI, then anything over it should be deductible. Most taxpayers do not reach an OOP amount that's greater than 7.5% AGI. It tends to take a very low income, or very high medical expenses. More information, examples, and a list of deductible medical expenses can be found in IRS Pub 502 * disclaimer: I hope I didn't fat finger a number up there and completely throw off the math.

Typically criteria for approval does not include losses from the immediately prior WLS. For example, my father had a slipped band removed, and a few months later was re-banded. Although the criteria for band approval includes a BMI over 40, he was excluded from this due to his past. I am a soon to be band to sleeve revision (I'm mostly decided sleeve is what I want). My BMI is under 40 and I don't have comorbidities, but that will not be grounds for denial. However, if I had my band out 5 years ago, and had stayed at a normal weight since, and now wanted to be sleeved, I would most likely not be approved. (That's as my ins. co. explained it to me) I don't know what the statute of limiations, so to speak, is on duration you can go "unassisted" and maintain your BMI, and disqualification because of a low BMI.

All I have heard lately - and this is more through the grapevine/not official - many or most of the insurance companies are looking at excluding bariatrics alltogether, or imposing a "once in a lifetime" limitation that would include prior self-pay procedures. That's scary stuff!

Sorry, I have not checked here in a bit. Leslie - I have found out that my surgeon does revision surgeries at least 2 months apart. While I'm impatient, I do like that idea. A lot of surgeons will do them in one procedure and although I'm not a surgeon, requiring some down time seems like the way to do it. During the first surgery he removes the band, and repairs adhesions (the exterior damage to the organs & surrounding tissues that we're all going to have). The second procedure is to create the sleeve. I had my EGD two weeks ago, but haven't yet been able to meet with the surgeon. I won't until we receive the insurance approval (nice, huh?) My surgeon is very skilled and I am a "repeat customer" but I still have a ton of questions for him around the revision process. E.g. if the highest risk is leak, and a leak is repaired by applying mesh and blanket sutures, can you just do mesh & blanket sutures from the beginning? Leesha - good to hear from you. We have extremely similar stories except for our initial bandings. As I mentioned earlier, I have been given the option of keeping my slipped band, and even getting fills as tolerated. But when I started thinking about it, I just wasn't sure how that was an option. I'm at higher risk for additional prolapse, I already know I can't tolerate fills -- the EGD left me very swollen and it was about 8 days before I could eat solids. The swelling immediately brought back all the reflux and heartburn, and removed ANY thought I might have given to keeping the band because it's completely evident that anything brining about restriction (internal, like the EGD or a stuck piece of food -- or external, like a fill) is going to renew the symptoms I have. (Like you I have no pain, and no sickness... but I do have a feeling of pressure most of the time when I eat solids, and if that pressure isn't gone by bedtime, I will start refluxing within 10 minutes of falling asleep... it's truly like clockwork). I do need to follow up with a question to my surgeon's office. The xray showed a "profound" slip -- I didn't see the xrays, but I was told that the angle of the band was almost opposite of what it should be, and that based on the xray alone I would not be a candidate for repositioning/rebanding. The EGD showed a "partial" slip. So I don't know if the slip has actually improved since getting completely unfilled, or if those two things that seem a little contradictory actually aren't. There are still three people I know, banded longer than me, that I'd like to get back in touch with. Aside from those three, whose band status is "unknown" -- 100% of the people I know banded around my time or earlier have had slips and/or removals. EVERYONE. The band helped me get almost to goal weight. It definitely helped me conceive my daughter. I'm not anti-band, and I don't "hate" my band. I wish I had known then, the current stats for failure rates. If I could trust myself to keep the weight off, I would have it removed and never regret a thing, and never look back. But I don't trust myself with that (I'm still carrying my 40 lbs of "pregnancy" weight, and my DD will be 3 in October). Do I think it can help people lose weight -- I know it can. Do I think it's a long-term solution -- absolutely not.

I've had a lap-band for going on 6 years. Feel free to PM me if you have any questions. I will give you my opinion, or collective data - whichever you prefer. I'm here researching revision, so my experience isn't the best, but it has been good. I'm happy to answer any questions. I don't want to sound harsh, but you might want to put things on hold a bit. "I'll get whatever insurance covers, but I don't know what that is" is not going to set you up for the most success. RNY and VSG are apples and oranges, and your preparation for each, expectations, recovery, etc. are going to be really different. It's not something you want to be a surprise. Or - maybe you're equally prepared for either? BTW, I see you have 215 lbs to lose. I had 200 to lose, when I got my band. I am osing my band, and even if I weren't, I would not advocate for the band as a long term procedure -- but it is possible to be a higher BMI patient and reach goal with a band.

Protein will matter more than calories, and so will time (generically). For hairloss, that is. Neither may matter if your hairloss is the result of body trauma, and not a deficiency. It's pretty unusual for hairloss to last much longer than a year, if that helps you feel any better.

First - congratulations! Second - I'm reminded of Napoleon Dynamite: I like your sleeves. They're real big.

Tell us a little about where you work. You don't need to give any identifying information, but how many employees are there? Are you offered, or have you elected, STD coverage? WHy does your supervisor consider your procedure an "elective" surgery? Has he or she been told what the procedure is? Is your workplace large enough that you have an HR department? Is 4 weeks the average time off? That seems like a lot, but you do need to work within your own comfort levels, and I dont' know -- I haven't had it yet.

Let me ask you guys this - does the PPI you are taking STOP the reflux, or just make it less harmful/gross? I ge the difference between PPI & antiacids, but I have a slipped band and when anything happens to increase the restriction, I get pretty severe reflux. If I take an antiacid, I still reflux, but it's a neutralized liquid instead of the burning acid. Still gross. I've tried taking a PPI in hopes that it would stop the reflux, and it doesn't. Again, I still reflux, but what I'm refluxing doesn't hurt/burn. In both cases it's like refluxing Water, but a little more gross... Since the PPIs are shutting down the pumps, I'm thinking you still reflux - sine reflux isn't specific to a state or degree of acid in your stomach.

Fat faces hang. It's gravity. Faces are one of the first places most people lose, so it's pretty normal to appear younger. UNLESS you lose weight at a really old age, and the fat is what was keeping your skin from just hanging. That happened to my grandma... ugh... not pretty. I was always amazed at how youthful she looked for her age, until she lost weight and her face started to hang. (I don't mean that in a cruel way, but it's just how it is) The one thing I noticed right away when I first started looking at before/after pics was that everyone, even people pretty far from their goal, had very prominent collar bones. Having now gotten (at least once) close to my goal, I think it's two things. I do, and it seems most do, lose weight from the upper half of my body first. So it makes sense that even only halfway (or less!) collar bones might be unusually prominent. I also find myself sometimes trying to look skinnier in pics, and the "turtle neck" (you know - extending your neck a bit to get rid of any excess chins, and to emphasize the bones/tendons/etc around the neck to appear slimmer) is a great way to do this, but also tends to deepen the indentations around collar bones. Soeither it's real progress, or faux progress, but either way it's great.

I would hope you do not need to worry about a "riot act" for expressing your feelings.I will read a riot act to anyone who does that to you. (j/k) So much to say here. Honestly, there's no way to "be" then. You just are. And since it will cone gradually, you will adjust gradually. Your concern over this makes me wonder about the genesis of your weight problem. I'd guess your an emotional eater - since your fears of losing weight are very emotionally based - what are your eating triggers? What do you get from food? What does your fat give you? (I know not everyione agrees with this idea, and that's an entirely different post, but I believe 100% that we do things because we get something out of them... and that includes being fat even though we all physically have an ability to not be fat... we are... so I believe that we are for a reason. Usually that reason is control. Sometimes it's security, or protection, or distance. Sometimes its etc etc. Do you know what you get? If you do, adjustment will be 10000 times easier.

As long as your Vitamin is not "time release," "enteric coated" or otherwise specifying that you must swallow the whole pill, you should be able to chew it. It will not taste nice! (THe chewable ones don't either, but they taste better). Centrum complete makes a chewable, if you're having a hard time finding one. If you're taking additional supplements, they may or may not be advisable to chew. It depends on how they will interact with things like your tooth enamel.